Pharmacy Programs Optimization Specialist

Regular Exempt GENERAL DESCRIPTION: Responsible for the execution, monitoring, and evaluation of clinical pharmacy initiatives to ensure they align with organizational goals, regulatory requirements, and performance standards. Supports the development of cost-effective, patient-centered interventions, analyzes clinical and operational data, and collaborates across departments to drive measurable improvements in quality, outcomes, and pharmacy program performance. ESSENTIAL FUNCTIONS: Perform comprehensive pharmacy data analysis to evaluate program outcomes, identify trends, uncover performance gaps, and recommend data-driven solutions. Handle continuous process improvement efforts by identifying workflow inefficiencies, implementing best practices, and driving operational excellence across pharmacy programs. Analyze vendor and client performance reports, monitor Key Performance Indicators (KPIs), and communicate results and opportunities for improvement to pharmacy leadership and clinical teams. Collaborate with cross-functional departments, vendors, and business partners to identify operational issues, implement corrective actions, and optimize pharmacy program performance. Serve as the liaison between pharmacy clinical program owners and operational teams to ensure timely execution, monitoring, and reporting of pharmacy interventions and initiatives. Maintain operational and clinical dashboards that measure program performance, productivity, quality, turnaround times, and overall business impact. Develop and distribute reports, presentations, and executive summaries to provide stakeholders with actionable insights and support informed decision-making. Generate, validate, and maintain regulatory reports, audit documentation, and compliance records to support internal and external audit readiness and regulatory requirements. Coordinate, implement, and track pharmacy clinical programs, ensuring deliverables are completed accurately, efficiently, and within established timelines. Monitor, document, and report intervention outcomes to ensure compliance with contractual requirements, organizational standards, and quality objectives. Prepare, validate, and distribute Target Member Lists (TMLs) and other outreach tools to support clinical interventions, member engagement, and program tracking activities. Support and comply with initiatives to achieve STARS Ratings goals by contributing to adherence, medication safety, quality performance, and other organizational objectives. Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM

QUALIFICATIONS:
Education and

Experience:
Bachelor's Degree in Health Services Administration, Natural Sciences, or related areas. At least two (2) years of experience in operational processes, health services and/or clinical programs administration, preferably from the Pharmaceutical and/or Healthcare Industry. "Proven experience may be replaced by previously established requirements." Certifications / Licenses: Not required. Other: Advanced proficiency in Microsoft Excel is preferred. Understanding of pharmacy operations, Pharmacy Benefit Management (PBM) processes, and healthcare business practices is preferred. Strong knowledge of process optimization, performance improvement methodologies, and operational workflow management. Languages: Spanish – Advanced (comprehensive, writing and verbal) English – Advanced (comprehensive, writing and verbal) “We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.”